In this sequel to Second Chances, Alex and Regina embark on a medical mission to a sugarcane plantation in the Dominican Republic. Soon after arriving they discover that all is not as it appears and what lies beneath the thin veil of civilization is fraught with peril and deception. Faced with heart-wrenching poverty and the plight of society’s most vulnerable they must triage and help those they can without the benefit of sophisticated tools using only their experience and ingenuity.

Amidst the challenges, Alex develops an unlikely friendship with one of the nuns who oversees the orphanage and discovers an evil so pervasive and sinister it places all of their lives at risk. Ultimately, Alex and Regina are faced with making an extraordinarily difficult decision that could change the course of their lives forever.